Published: May 24, 2011
Updated: May 24, 2011
Learn how uterine fibroids are detected, when they should be treated, and what treatment options are available.
Fibroids are typically discovered by using symptom history in combination with pelvic examination.
It is important to have regularly scheduled pelvic examinations and PAP smear performed by a primary health care provider (family physician, gynecologist, nurse practitioner, or physician assistant).
Ultrasound is often used for evaluating the presence of fibroids and ovarian problems. Magnetic resonance imaging (MRI) is another imaging tool used to better define the size, extent, and distribution of fibroids.
MRI allows for more precise treatment planning for alternative therapies or minimally invasive surgical procedures.
Once fibroids are confirmed to be the cause of symptoms, a physician can discuss the potential treatments that are available today.
This is dependent upon the individual. The main reason to treat fibroids is to improve a woman’s quality of life.
Fibroid-related bleeding can cause women to miss work, or compromise their social life and travel plans. Some bleeding can be severe enough to cause anemia or require blood transfusion. In this situation, the treatment is more required than optional.
Urinary frequency can impact sleep patterns and also make a long trip in the car difficult. The pain and pressure related to fibroids can even require narcotic medication to make the woman able to tolerate her symptoms.
Since the majority of fibroids do not cause symptoms, there is a possibility the fibroids may not need to be treated.
Once symptoms develop, medical management should be the initial therapy. This includes treatment with non-steroidal anti-inflammatory agents, oral contraceptives, progesterone analogs, or gonadotropin-releasing hormone agonists (Lupron).
The decision for further medical management depends on the patient's age, the size of the fibroids, the desire for future pregnancy, and the severity of symptoms.
Surgical options exist for women who do not respond to medical therapy. Hysterectomy has traditionally been offered for their treatment.
Other surgical options include:
Detailed discussion of the surgical options can be obtained by a consult with your gynecologist.
Uterine fibroid embolization (UFE) and MRI-guided focused ultrasound are treatment alternatives for symptomatic fibroids.
UFE has been used since 1999 and has been studied thoroughly. It is an effective treatment alternative for women with symptomatic fibroids. Read a supporting September 2001 article from Applied Radiology:
You may contact the offices of Michael J. Miller MD, David Sopko, MD, and Waleska M. Pabon-Ramos, MD, MPH, Division of Vascular-Interventional Radiology, at Duke University Medical Center at 919-684-7280 or e-mail Debbie Semmel, FNP-BC, at firstname.lastname@example.org to make an appointment.